According to researchers, CAVS is common in the ageing population and will likely become an increasing economic and health burden.
So far, no medical therapies have proven effective in halting or reversing disease progression.
"Therefore, aortic valve replacement remains the only available treatment option," wrote scientists in the European Heart Journal.
However, they noted that improved knowledge of the mechanisms underlying disease progression had revealed that aortic valve calcification (AVC) may offer targets for diagnosis and intervention, opening up a potentially crucial role for vitamin K2.
"The discovery that vitamin K-dependent proteins are involved in the inhibition of AVC has boosted our mechanistic understanding of this process and has opened up novel avenues in disease exploration," they wrote.
Vitamin K is a fat-soluble vitamin consisting of two forms, namely phylloquinone (vitamin K1, VK1), present in green leafy vegetables, and menaquinones (vitamin K2, VK2), present in fermented food.
However, dietary intake of vitamin K is often insufficient, leading the researchers to state that supplementation was an attractive option for replenishing vascular stores to ensure optimal calcification inhibition.
Promising approach
They pointed to several studies that showed how vitamin K supplementation had improved vascular calcification, but added: "Although promising, these studies were limited by the short-term follow-up, precluding measurable effects on clinical endpoints.
“Recently, the first in-man RCT demonstrated that vitamin K supplementation decelerated valvular calcification on computed tomography (CT) in a small group of patients with CAVS. The effectiveness of vitamin K supplementation to reduce or hold calcification progression is currently (the) subject of investigation in multiple trials."
The paper was welcomed by Dr Hogne Vik, chief medical officer with vitamin K2 supplier NattoPharma, who said that researchers were now recognising the ineffectiveness of medical therapies, and therefore, turning the spotlight on "efficacious supplemental alternatives".
The review concluded: "The pathophysiological mechanisms involved in CAVS initiation and progression are being rapidly elucidated, and include inflammation, fibrosis, and calcification.
"With this advancing knowledge, we have identified novel therapeutic targets like vitamin K and new imaging techniques that can be used to test the efficacy of novel agents and further inform our pathophysiological understanding."
Source: European Heart Journal
https://doi.org/10.1093/eurheartj/ehx653
"Calcific aortic valve stenosis: hard disease in the heart: A biomolecular approach towards diagnosis and treatment"
Authors: Frederique E C M Peeters, et al.